Healthcare Provider Details

I. General information

NPI: 1154493948
Provider Name (Legal Business Name): SAVED BY GRACE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 HEPBURN ST
WILLIAMSPORT PA
17701-5004
US

IV. Provider business mailing address

507 HEPBURN ST
WILLIAMSPORT PA
17701-5004
US

V. Phone/Fax

Practice location:
  • Phone: 570-854-7669
  • Fax: 570-323-9149
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP414026L
License Number StatePA

VIII. Authorized Official

Name: STEPHEN KAMINSKI
Title or Position: OWNER
Credential: RPH
Phone: 570-323-7733